The objectives of the proposal are to develop automated techniques to increase the effectiveness and efficiency of ambulatory care and to evaluate the usefulness of these techniques. The proposal assumes the existence of an automated information system, specifically COSTAR (COmputer-STored Ambulatory Record) in small to moderate-sized ambulatory care facilities. The techniques to be developed are: 1) canned quality assurance protocols to assist in developing and implementing quality of care assessment; 2) routines for carrying out database analysis activities; 3) a Medical Query Language for conducting locally specified database research; and 4) COSTAR enhancements that increase the level of coding of medical data and that permit provisional implementation of various algorithms for archiving medical data. The techniques will be implemented in collaborating sites and evaluated by means of surveys, by documentation of use and effects of use, and by comparison of cost with other automated methods and with manual methods.